Objective To construct an ISBAR [Identification (I), Situation (S), Background (B), Assessment (A), Recommendation (R)] framework for anesthesia handover in the post‑anesthesia care unit (PACU) and explore its application. Methods The PACU handover indicators were determined using the Delphi method by expert correspondence, in order to construct a PACU handover checklist based on the ISBAR framework for anesthesia handover (hereinafter referred to as the checklist), while related training was provided to all medical staff involved in the study. A total of 424 patients were enrolled from September to October, 2020. According to the random number table method, they were divided into two groups (n=212): group A (transferring all items according to the requirements of the checklist, without the use of the checklist at handover) and group B (transferring all items according to the requirements of the checklist, with the use of the checklist at handover). Primary outcomes included the handover items and time of the two groups; Ramsay Sedation Score, RSS Agitation score and Visual Analog Scale (VAS) score of the two groups at the time of extubation (T0), 5 min after extubation (T1), and at the time of discharge from the PACU (T2); adverse events in the PACU, the incidence of second handover, and the satisfaction rate of medical staff. Secondary outcomes included the time from PACU admission to extubation, the length of PACU stay, and the length of hospitalization stay in both groups. Results Compared with group A, patients in group B showed increased handover items, extended handover time, reduced time from PACU admission to extubation, and shortened length of PACU stay (all P<0.05). Group B also presented better Ramsay sedation score and RSS agitation score at T0, and better VAS score at T0 to T2 than group A (all P<0.05). The incidences of adverse events and secondary handover in group B were lower than those in group A (all P<0.05). There was no statistical difference in the length of hospitalization stay, Ramsay sedation score and RSS agitation score at T1 and T2 between the two groups (all P>0.05). The satisfaction rate of medical staff toward the checklist was 91.3%. Conclusions The ISBAR framework for anesthesia handover is successfully constructed, which is feasible, and can effectively avoid handover omissions, improve the quality of handover, and reduce complications and adverse events, making the communication among medical staff concise and time‑saving, and improving the rate of satisfaction of medical staff.